Laparoscopic surgery and other forms of minimally invasive surgery (MIS) procedures include a large proportion of surgical interventions in the United States. Techniques have greatly improved since the late 1980s, but the goal of emulating traditional (e.g., open) surgery has not been reached. Instrumentation has been miniaturized, image quality has been increased, and the addition of robotics promises to compensate for human limitations. Yet there is a limitation of MIS: unlike open surgery, the operative field is dependent on a single viewpoint provided by the telescope and camera, and every member of the surgical team sees the same image. The consequences are that a) the displayed image depends entirely on the view captured by the cameraman (e.g., the person holding the telescope and camera), who can be subject to fatigue, tremor, or poor instructions from the surgeon, resulting in suboptimal capture (and therefore display) of the operative field; b) tunnel vision (e.g., a risk of blind spots and unseen injuries if the telescope and camera shows a zoomed-in image of the surgical field); c) the image can be a panoramic view of the surgical field, which shows a wide angle—but removes any detail, or a close-up, which creates tunnel vision—but not both; and d) there can only be one surgical action at any given time.
At best, this set-up prevents multitasking, simultaneous performance of multiple maneuvers and observation of the field from several points of view (all features of open surgery); at worst, it offers a suboptimal view of the field and endangers the patient by omitting critical parts of the operative field. As a result, and despite its overall safety, laparoscopic operations are still not as safe as their traditional, open counterparts.